1457711202 NPI number — OAKLAND INTEGRATED HEALTHCARE NETWORK

Table of content: RONNIE A. POLLARD MD (NPI 1104871243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457711202 NPI number — OAKLAND INTEGRATED HEALTHCARE NETWORK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OAKLAND INTEGRATED HEALTHCARE NETWORK
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457711202
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 430150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PONTIAC
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48343-0150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-724-7600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1701 BALDWIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PONTIAC
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48340-3412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-724-7600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/07/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BRINSON
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
248-724-7600

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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